An unusual case of subcutaneous emphysema

Subcutaneous emphysema of gastro-intestinal origin is a rare occurrence, particularly when localized in the lower limb (Fox et al., 1978; Oetting et al., 1955). Until recently 51 cases of subcutaneous emphysema of gastro-intestinal origin have been reported and 23 of these were confined to the lower limb. To our knowledge the aetiology of this patient's soft tissue gas is unique. A 51-year-old male was admitted to our hospital on 3/10/79 complaining of left hip pain of five months' duration which had become more severe over the preceding three weeks. He was unable to weight bear for this period and for two days there had been swelling in the hip region. On examination, temperature was 37.9°C, pulse 88 per minute. Abdominal examination revealed mild tenderness deep in the left iliac fossa but there were no other abdominal signs or symptoms. On rectal examination, there was mild benign prostatic hypertrophy and tenderness and fullness of the left pararectal space. There was pain on movement of the left hip ...